Soft Tissue Neck IN COMPUTED TOMOGRAPHY Frank Cairo R.T. ( R ) ( CT ) ( MR )
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Transcript of Soft Tissue Neck IN COMPUTED TOMOGRAPHY Frank Cairo R.T. ( R ) ( CT ) ( MR )
Soft Tissue Neck
IN COMPUTED TOMOGRAPHY
Frank Cairo R.T. ( R ) ( CT ) ( MR )
Learning Objectives
• To describe clinical indications for C.T. examinations of the neck soft tissue. To understand and recognize anatomy and landmarks. To show the proper scan protocols and procedures.
TOPICS• Gross anatomy• Neck anatomy facts• Patient prep• Indications• Patient prep• Scan protocols• Soft tissue neck slides
Gross Anatomy
• A horseshoe-shaped bone situated in the anterior midline of the neck between the chin and the thyroid cartilage
• Level with the third cervical vertebra (C3) behind
• The hyoid is only distantly articulated to other bones by muscles or ligaments
Hyoid Bone
Hyoid Bone
Hyoid Bone
Thyroid Cartliage
• Know as the Adams apple• Largest and most superior in the neck• Level with C3-4• protect the vocal cords• Does not make a ring around trachea
Thyroid Cartliage
Cricoid Cartliage
• At the level of C6• Makes a ring around trachea• Applies attachments for muscles and
ligaments
Cricoid Cartliage
Thyroid Gland
• Largest gland in the neck• Has 2 lobes connected by the isthmus• Sometimes had pyramidal lobe• Controls how quickly the body uses energy,
makes proteins, and controls how sensitive the body is to other hormones
• Produces thyroid hormones
Thyroid Gland
Carotid Anatomy
Carotid Artery
Veins of the neck
Veins of the neck
Neck Circulation
1- rt common carotid artery2- rt internal jugular vein3- rt.subclavian artery4- brachiocephalic artery5- rt and lt brachiocephalic vein6- SVC7- lt common carotid artery8- lt internal jugular vein9- lt.subclavian artery10 – arotic arch
Lymph Nodes
Lymph Nodes
Salivary Glands
• exocrine glands, glands with ducts, that produce saliva
• Saliva for chemical digestion• 3 main glands and several minor• Parotid, Submandibular, and Sublingual
Salivary Glands
Salivary Glands
Airway
General Imaging Methods—Neck• Performed supine with neck slightly extended• Most often done in helical mode• IV contrast is used, unless contraindicated
– Split-bolus injection technique is used by some institutions• The goal is to allow sufficient time after contrast administration for
mucosa, lymph nodes, and pathologic tissue to enhance, yet acquire images while the vasculature remains opacified
• Neck broken into 3 compartments– Visceral
• Contains organs– Vascular
• Contains arteries and veins– Muscular
• Neck muscles– Landmarks
• Larynx c3-c6• Cricoid cartilage c5-c6• Carina T4-T5• Carotid bifurcation c3-c4• Thyroid cartilage c3-c4
Neck Anatomy Facts
• Diagnosis of neoplasms• Infections and abscesses• Thyroid mass• Salivary gland disorders• Vocal cord disorders
Indications
Patient Preparation• If exam is done with I.V. contrast patient must be
NPO 4-6 hours• Lab work for I.V. contrast exams• Follow all routine precautions for contrast
SINUSES
COLLIMATION 0.75mm
SLICE THICKNESS 3-5MM
FOV 14-20 CM
PITCH 1.0
WINDOW 450/30 NECK 4000/300 BONE
COLLIMATION 16X0.75
FEED/ROTATION 12 MM
INJECTION 100-120 ml @ 2-3ml/sec delay 25-30 sec
Soft Tissue Neck1- SVC
2- Brachiocephalic Artery
3- Lt. Common Carotid
4- Lt. Subclavian Artery
1
2
3
4
Soft Tissue Neck
1 2 34
5 1- Thyroid Gland
2- Common Carotid
3- Internal Jugular
4- Verterbral
5- Rt Subclavian
Below
Bifurcation
Above
cc cc IcEc
Neck
1
23 4 5
6
1- Internal Juglar vein
2- Submandibular Gland
3- Carotid Biufcuation
4- Hyoid Bone
5- epiglottis
6- Vertebral Artery
Neck1- Vertevbral Artery
Salivary Gland
11- Parotid Gland
Salivary Gland
1
1- Submandibular Gland
Neck1- Basilar Artery
2- Internal Carotid
Soft tissue neck
Copy right © 2007 by the American Roentgen Ray Society
Groell, R. et al. Am. J. Roentgenol. 2001;176:1571-1575
--85-year-old woman with metastases from squamous cell carcinoma of hypopharynx